I attended a Mental Health Act conference, at which the keynote speaker was Genevra Richardson, the day after the publication of the government s green paper on reform of the Mental Health Act 1983.

The speakers were thrown into disarray by the green paper s publication, of which they had had no warning, although Professor Richardson had chaired the expert committee on whose report the green paper is based.

I have a particular concern about the fate of hospital managers but I had always felt that I was a lone voice. I was therefore surprised that the first questions all concerned the abolition of the hospital manager s role. The questioners were not non executive directors or generic hospital managers, but professionals in all other parts of the service.

The green paper does not offer us the opportunity of consulting on the decision to end the role of the hospital manager . Nor does it, or the Richardson report, or indeed Genevra Richardson herself, offer any reasons why they wish to see an end to this role. But many people can now see the value of a local layer of protection for patients being treated under compulsion.

Patricia Gregory Chair Kingston and District Community trust